Child:
Original Article
care, health and development
doi:10.1111/j.1365-2214.2011.01230.x
Genetic and environmental influences on sleep
problems: a study of preadolescent and
adolescent twins cch_1230 638..641
M. Moore,* J. Slane,† J. A. Mindell,*‡ S. A. Burt† and K. L. Klump†
*Sleep Center, The Children’s Hospital of Philadelphia, Philadelphia, PA
†Department of Psychology, Michigan State University, East Lansing, MI, and
‡Department of Psychology, Saint Joseph’s University, Philadelphia, PA, USA
Accepted for publication 11 November 2010
Keywords Abstract
adolescence,
environmental influences,
Background/Aim The aim of this study was to examine the extent to which additive genetic,
genetics, sleep shared environmental and non-shared environmental factors contribute to adolescent and
preadolescent sleep problems.
Correspondence: Methods The sample consisted of a cohort of 270 monozygotic and 246 dizygotic twins from a
Melisa Moore, PhD, Sleep
Center, The Children’s university-based twin registry.
Hospital of Philadelphia, Results Results demonstrated that genetic and environmental influences each appear to be
3405 Civic Center
Boulevard, Philadelphia,
important to adolescent sleep problems.
PA 19104, USA Conclusions While the magnitude of genetic influence on sleep problems was consistent with
E-mail: mooremel@email. findings from the adult literature, it was smaller than in studies with younger children, suggesting
chop.edu
genetic effects may be less influential in adolescence and adulthood.
Funding:
National Institute of
Mental Health: 1 R21 MH
070542-01 (Klump)
Intramural Grants
Program, Michigan State
University: #04-IRGP-232
(Burt)
Intramural Grants
Program, Michigan State
University: #71-IRGP-4831
(Klump)
While studies on the heritability of sleep problems in adoles-
Introduction
cents are lacking, the literature provides evidence for genetic
Adolescence is widely recognized as a period of development influences on sleep in pre-school and school-aged children, as
associated with less than optimal sleep duration and increased well as adults. For example, in 3-year-old twins, van den Oord
daytime sleepiness. Although the combination of behavioural and colleagues (1996) found that 69% of the variance in sleep
and environmental factors, normative developmental changes, problems was due to genetic factors, while 31% was due to
intrinsic sleep processes and/or sleep disorders have been shown non-shared environmental influences. Additionally, Gregory
to affect adolescent sleep, genetics may also be a contributing (2008) found in a study of 8-year-old twins that the majority of
factor. the variance in parasomnias and dyssomnias was due to genetic
638 © 2011 Blackwell Publishing Ltd
Genetic influences on adolescent sleep problems 639
factors (51% and 71%, respectively), with the remaining vari-
Measures
ance accounted for primarily by non-shared environment. With
regard to specific sleep disorders, Nguyen and colleagues (2008)
Demographics
found that sleep terrors at 18 months and 30 months were
explained by genetic (44% and 42%, respectively) and non- Demographic information was collected from a parent
shared environmental factors (56% and 58%, respectively). questionnaire, which included information about each twin’s
Finally, a recent longitudinal study by Gregory and colleagues age, ethnicity, birth weight and gender, as well as parent income
(2009b) found that sleep problems remained stable from 8–10 and education.
years of age and that most of the variance could be explained by
genetic and non-shared environmental influences at both 8 Zygosity
years (63% genetic factors, 32% non-shared environment) and
at 10 years (66% genetic factors, 7% shared environment, 27% Zygosity was determined using a physical similarity ques-
non-shared environment). In combination, the evidence sug- tionnaire, which has demonstrated 95% accuracy (Plomin et al.
gests that genetic factors play a substantial role in the sleep 2008). Indeterminate zygosity was resolved by one of the
problems of young children. project’s principle investigators, who reviewed photographs
Similarly, at least one study of adult 17- to 88-year-old of each dyad and questionnaire results.
twin pairs (Heath et al. 1990) estimated that genetic factors
accounted for 33% of the variance in sleep quality and dis- Sleep composite
turbance and 40% of the variance in sleep patterns, while The sleep composite score was derived from the four sleep-
there was no effect of shared family environment. Additionally, related questions on the Child Behavior Checklist (CBCL;
this study found no decline in the magnitude of genetic Achenbach 1991a), which was completed by the parent, and the
contribution with age. Youth Self Report (YSR; Achenbach 1991b), completed by the
For other behavioural conditions, such as eating disorders adolescent. The CBCL and YSR are widely used screening mea-
and anxiety, there are developmental differences in genetic and sures designed to identify child and adolescent behaviour and
environmental effects that provide important clues about emotional problems, and the reliability and validity of both
key aetiological factors and possible points of intervention. have been well documented. Items used in this study each indi-
Thus, the purpose of the current study was to use a twin sample cated a sleep problem including ‘overtired’ (item 54), ‘sleeps less
to investigate the magnitude of genetic and environmental than most kids’ (item 76), ‘sleeps more than most kids during
influences on sleep problems in adolescents. the day and/or night’ (item 77) and ‘trouble sleeping’ (item
100), which have been used in other studies of sleep problems in
Methods youth and have been compared with both subjective and objec-
tive measures of sleep (Gregory et al. 2009a). Because sleeping
Participants less than most children and sleeping more than most children
Participants included 270 monozygotic (MZ) and 246 dizygotic are independent symptoms (similar to eating behaviour on a
(DZ) twins and their mothers from the Michigan State Univer- depression inventory), no items were reverse scored. Each item
sity Twin Registry (MSUTR; Klump & Burt 2006). The sample was given a score of 0 (not true), 1 (somewhat or sometimes
ranged in age from 10–17 with a mean age of 12.68 ⫾ 1.51 years. true) or 2 (very true or often true), and the higher score (parent
Most of the subjects were female (61.1%), White (86%), and or child) for each item was used as the score for that item. The
had a family income of more than $60 000 (61.8%). sum of these scores comprised the composite sleep variable,
which ranged from 0 to 8 with higher scores indicating worse
Procedure outcomes. Cronbach’s alpha for the sleep composite was 0.70.
This study involved a secondary analysis of data collected via the
Analyses
MSUTR. Twins were initially recruited for the adolescent
MSUTR using birth records. This study was approved by the Twin intraclass correlations were calculated to provide initial
Institutional Review Board at Michigan State University, and indications of genetic versus environmental (i.e. shared and
written informed consent/assent was obtained from a parent/ non-shared) influences on sleep problems. Given that MZ twins
guardian, as well as the adolescents. share all of their genes, and DZ twins share, on average, only half
© 2011 Blackwell Publishing Ltd, Child: care, health and development, 37, 5, 638–641
640 M. Moore et al.
of their segregating genes, greater MZ relative to DZ twin cor- lation was high (0.70, P < 0.05), the MZ correlation was some-
relations suggest that genetic factors are important for the trait what higher than the DZ correlation (0.60, P < 0.05), although
in question. By contrast, similar MZ and DZ twin correlations MZ/DZ twin differences in correlations were non-significant (z
suggest that shared environmental factors account for associa- = 1.26, P = 0.10), and the MZ correlation was less than 1.00. As
tions. Finally, non-shared environmental influences are impli- indicated in Table 1, the best fitting model for sleep problems
cated if the MZ twin correlation is less than 1.00. It must be was the ACE model. Parameter estimates indicated that sleep
noted, however, that an MZ twin correlation of less than 1.00 problems are influenced predominately by shared environmen-
indicates the presence of both non-shared environmental tal influences (42%) with genetic factors accounting for 30% of
factors and/or measurement error. the variance and non-shared environmental effects accounting
Univariate twin models were fit to raw data using the for 28% of the variance.
maximum likelihood option in Mx to directly examine additive
genetic (A: the effect of individual genes summed over loci),
Discussion
shared environmental (C: environment common to siblings that
acts to make them similar to each other) and non-shared envi- Findings from this study were that shared environmental influ-
ronmental [E: environmental factors (and measurement error) ences made particularly strong contributions to adolescent
differentiating twins within a pair] influences on sleep problems. sleep problems. The heritability of sleep problems in this study
Initially, the unrestricted ACE model was fit to the data. This (30%) is consistent with findings from the adult literature
model allows variances, covariances and means to be estimated (Heath et al. 1990), suggesting that the degree to which genetic
freely by minimizing the -2 times log likelihood of data (-2lnL). effects influence sleep problems from adolescence to adulthood
Next, submodels of the ACE model (i.e. AE, CE and E) were may be relatively consistent. While longitudinal studies are
examined to determine if a reduced model provided a better fit to clearly needed, this study in comparison with other research
the data. The fit of the various submodels was examined using (Heath et al. 1990; van den Oord et al. 1996) suggests that the
a likelihood-ratio chi-squared difference test (-2lnLD) and impact of genetics on sleep problems may be stronger during
Akaike’s information criteria (AIC = c - 2 ¥ Dd.f.). The pre-school and school age (63–69%). On the other hand,
likelihood-ratio chi-squared difference test (2lnLD) examines the effect of shared environment seems to follow an inverse
differences in -2lnL values and degrees of freedom between U-shaped pattern, with research demonstrating a minimal
nested models. If the chi-squared difference test is non- effect (0–7%) during pre-school, school age, and again during
significant, then the most parsimonious (i.e. reduced) model was adulthood (Heath et al. 1990; van den Oord et al. 1996; Gregory
preferred. The AIC also evaluates model fit, and does so placing et al. 2009b). Interestingly, the current study suggests that ado-
some value on parsimony. Lower AICs indicate a better fit. lescence may be the period of development where shared envi-
ronmental factors play a significant role. It may be that the
magnitude of environmental influence is greatest during ado-
Results
lescence where factors such as family routines, school start
Twin intraclass correlations demonstrated that all three factors times, parental limits around sleep schedules and electronic use,
(e.g. genetic, shared and non-shared environmental factors) and academic, extracurricular and social demands play such an
appeared to be important for sleep problems; as the MZ corre- overwhelming role in determining sleep patterns.
Table 1. Univariate twin models examining genetic and environmental influences on sleep problems
Standardized parameter estimates Test statistics
2 2 2
Model a c e -2lnL d.f. -2lnLD (d.f.) P AIC
ACE 0.30 (0.05, 0.58) 0.42 (0.16, 0.58) 0.28 (0.22, 0.38) -51.33 479 – – -1009.33
AE 0.73 (0.65, 0.79) – 0.27 (0.21, 0.35) -42.53 480 8.80 (1) <0.01 -1002.53
CE – 0.64 (0.56, 0.71) 0.36 (0.29, 0.44) -42.82 480 8.51 (1) <0.01 -1005.82
E – – 1.0 (1.0, 1.0) 78.62 481 129.95 (2) <0.001 -883.38
Ninety-five per cent confidence intervals are in parentheses. The best fitting model is indicated by bold type.
a2: additive genetic effects; c2: shared environmental effects; e2: non-shared environmental effects; -2lnL: -2 times log likelihood of data; d.f.: degrees of freedom;
AIC: Akaike’s information criterion; -2lnLD: differences in -2lnL values between the ACE fully unconstrained model and submodels.
Models: A: the effect of individual genes summed over loci; C: environment common to siblings that acts to make them similar to each other; E: environmental
factors (and measurement error) differentiating twins within a pair.
© 2011 Blackwell Publishing Ltd, Child: care, health and development, 37, 5, 638–641
Genetic influences on adolescent sleep problems 641
Findings from this study should be interpreted in the context
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